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Medically Reviewed By:

2026-05-01

  • Condition
  • Arterial
  • Severity: Urgent

Aortic Aneurysm

Also Known As: AAA, abdominal aortic aneurysm, thoracic aortic aneurysm, aortic dilation
An aortic aneurysm is a localized enlargement — bulge or dilation — of the aorta, the body’s largest artery, to a diameter 1.5 times or greater than its normal size. Aortic aneurysms are a potentially life-threatening condition because they grow silently and, if untreated, can rupture — causing massive internal hemorrhage with a mortality rate exceeding 80%. Elective repair, when performed before rupture, carries a dramatically lower risk.

Abdominal vs. Thoracic Aortic Aneurysms

Abdominal aortic aneurysms (AAAs) are the most common type, located in the portion of the aorta within the abdomen. Most AAAs develop below the renal arteries (infrarenal). The normal aortic diameter is approximately 2 cm; an AAA is typically defined as a diameter greater than 3 cm, with repair generally recommended when the diameter exceeds 5.5 cm in men or 5.0 cm in women, or when the aneurysm grows more than 0.5 cm in six months. Thoracic aortic aneurysms (TAAs) involve the portion of the aorta in the chest.

Risk Factors for Aortic Aneurysm

The primary risk factors include age over 65, male sex, smoking history, high blood pressure, atherosclerosis, and family history (a first-degree relative with AAA significantly increases risk). AAA is approximately four times more common in men than women, though women have a higher rupture risk at smaller diameters. The U.S. Preventive Services Task Force recommends one-time abdominal aortic ultrasound screening in men aged 65–75 who have ever smoked.

Aortic Aneurysm Symptoms

Most aortic aneurysms are asymptomatic and discovered incidentally on imaging performed for another reason. When symptoms develop they may include a pulsating sensation in the abdomen, deep back or flank pain, or abdominal fullness. Sudden, severe, tearing abdominal or back pain is the hallmark of rupture and requires emergency intervention.

Aortic Aneurysm Repair in Sarasota & Bradenton

Repair options include endovascular aneurysm repair (EVAR) — the less invasive approach — in which a stent-graft is delivered through small groin incisions and deployed within the aneurysm sac to reroute blood flow away from the weakened aortic wall. EVAR has largely replaced open surgical repair for anatomically suitable patients, offering faster recovery and lower short-term risk. Open surgical repair — in which the aneurysm is replaced with a fabric graft — remains the treatment of choice for complex anatomy unsuitable for EVAR and is highly durable.

SYMPTOMS

  • Majority are asymptomatic — discovered incidentally on imaging
  • Pulsating abdominal mass (can sometimes be felt)
  • Deep, persistent back or flank pain (expanding aneurysm)
  • Abdominal pain radiating to the back or groin
  • Rupture: sudden severe abdominal or back pain, hypotension — life-threatening emergency

DIAGNOSIS METHODS

  • CT Angiography +

    Gold-standard for aortic anatomy, size measurement, and surgical planning.

  • Abdominal Ultrasound (Screening) +

    Recommended once as a screening test for men over 65 who have ever smoked.

  • MRI Angiography +

    Used for surveillance in patients with contrast allergy or borderline kidney function.

TREATMENTS

RELATED CONDITIONS

FREQUENTLY ASKED QUESTIONS

  • How is an aortic aneurysm found before it ruptures? +

    Most AAAs are found incidentally on abdominal ultrasound, CT scan, or echocardiogram. Men 65–75 with any smoking history should undergo one-time AAA screening ultrasound, as recommended by USPSTF guidelines. Tell your doctor about any family history of aortic aneurysm.

  • Is EVAR better than open surgery? +

    EVAR has lower short-term procedural risk and a faster recovery, but requires lifelong surveillance imaging and has a higher rate of reintervention over time. Open repair is more durable and requires less long-term follow-up imaging. The best approach depends on your anatomy, age, and overall health.

  • At what size does an aortic aneurysm become dangerous? +

    Rupture risk increases substantially when AAA diameter exceeds 5.5 cm in men (5.0 cm in women), or when growth exceeds 0.5 cm in six months. Below these thresholds, surveillance ultrasound every 6–12 months is standard, along with cardiovascular risk factor management.